CO08 | Two cases of post-traumatic hemophagocytic lymphohistiocytosis: a potential cause of fever and cytopenia after trauma

Background: Post-traumatic hemophagocytic lymphohistiocytosis (PT-HLH) is a rare and potentially life-threatening condition characterized by uncontrolled activation of the immune system. The diagnosis is often made in the setting of exclusion of other conditions, such as infections and malignancies.Case Description: We present two cases of adult patients who developed fever and pancytopenia after severe trauma. While more common causes were excluded, we observed hepatosplenomegaly and elevated levels of inflammatory markers, serum ferritin, and triglycerides. On these findings we started to consider the diagnosis of post-traumatic hemophagocytic lymphohistiocytosis (HLH), which was then confirmed by bone marrow biopsy. Treatment with high-dose corticosteroids and intravenous immunoglobulin (IVIG) was initiated promptly after biopsy, resulting in rapid clinical improvement in both patients.Conclusions: This case report highlights the importance of considering PT-HLH in the differential diagnosis of patients with fever, cytopenias and multiorgan dysfunction following trauma. Early diagnosis and treatment of PT-HLH can lead to a better outcome.